Epogen

[hurlock1]

I just found out that Epogen, a medicine that is supposed to prevent anemia in dialysis patients, costs $700.00 a dose! I'm getting 3 doses a week. I don't have to pay it. The insurance company and medicare has to pay. But I'm hoppin' mad! Gold is on the market for $1136.00 per ounce. I wonder if the doctor is getting a kickback. What did they use before the got Epogen? Does anybody in here know how long Epogen has been on the market? Is there another drug that does the same thing? There is no "generic" Epogen because of some loophole in the law. Does anybody else have these same concerns?
jmz

[dwcrawford]

I just heard about Epogen yesterday... but nothing about the cost.

My nephrologist told the nurse to stop my epogen because my heomglobin was getting too high.  It's always (before dialysis been way to  low).  Nurse told him I never got Epogen.  Now I'm concerned.  Is he wanting to save money?  Was she already saving money but not giving it?  Do I need it?  You know, I don't reallly care about the cost as long as I get it if I need it.  I've paid Pretty Pennies for insurance all my life and by gosh I want some of it back now.

[paul.karen]

it depends on your center which type of drug you get.
Mine uses Arnesp (sp) instead of epo but both do the same thing.

if your hemoglobin is under 10 they will use epo or asnep to raise your hemoglobin lvls.  Normal lvls if i recall are between 12-14.  If you are getting epo or the other make sure your iron is not being deplenished which has its own set of difficulties if it gets to low.

When they put me on arsnep i had to also get drips of iron.  Both together raise your red blood cell count which raises your hemoglobin.

I think arsnep goes for about $350 a shot.

[*kana*]

Honestly, I'm not all that concerned how much money I cost my insurance company.  My life is worth it!   

[willowtreewren]

Carl hasn't needed Epo for several months, now. But when he did the protocols were very strict. They called it liquid gold! We had to sign out a tiny, tiny vial and bring back the unused portion when it expired before we could get the next vial. I gave Carl his shots at home since we do home hemo.

Aleta

[HubbysPartner]

Willowtreewren, do you give the medications through the port on the dialyzer?  I give all the medication through there and it makes it so much easier; no more sticking. 

[qwerty]

Epogen is utilized due to majority of people with ESRD dont produce "erythropoietin" which is produced by the kidneys to stimulate red blood cell production from the bone marrow. Yes it is very expensive and is goverment monitored due to abuse in the past by dialysis clinics to increase thier profits. There is very strict monitoring and nurses/clinics must document every amount given faithfully. There are strict guidelines in relation to administration. In the past before Epogen or Arnsep patients who had low hgb levels required blood transfusions. With the use of Epogen the need for blood transfusions has been significantly diverted. Imagine everytime you dropped below a certain level you would have to go to the hospital and recieve blood. So Epogen and Aransep has resulted in dramatic changes in the dialysis world. It can be given IV via your machine or subcutaneous (just under the skin). If given SQ tends to be more effective and requires smaller doses as it's longer acting usually given only once per week but IV avoids the stick yet usually requires to be given every treatment. Also if supplemented with doses of iron it can be a very effective medication in preventing anemia thereby avoiding the need for repeated transfusions.

[willowtreewren]

I would give the shot SubQ because that is the protocol in our center.

I give a student an insulin shot every day any way. I've been doing that for years. Giving shots doesn't bother me.

[Jie]

I get my own Procrit and inject by my self, so no any clinic or Medicare interferes with my use. I am very strict to follow my own protocol: to keep hemoglobin between 11 and 12. The normal level for men is >13. My private insurance pays for it.

[Maker]

Honestly, I'm not all that concerned how much money I cost my insurance company.  My life is worth it!   

Amen to that    Yes, Epogen & Aranesp are costly medications, but they are highly specialized injections, and there is no substitution for them.  They will be generic someday when the patent expires, but without patent protection we would not have any new drugs developed - it would not be worth it to the pharma companies! 

Prior to starting Dialysis I gave myself Aranesp injections at home - what a Godsend those injections were, as I was able to have a bit of energy again!  Now they give me Epogen at dialysis, but its PRN because sometimes when they check my HGB its within normal range, then after a week or 2 off the Epogen it will get low, and the cycle starts over again. 

DWCRAWFORD - you should ask to see your labs if you are questioning whether or not you really need it.  At least at my center, I request & receive & save copies of all my labs, that way I know for sure what my levels are and can make sure I am getting the best treatment and that nothing is missed.  Good luck to you 

[sico]

What did they use before the got Epogen?

I thought before the Epogen we all had to have more transfusions, wasn't that the only way to correct anemia previously?
Which increases antibodies and more problems with getting a transplant. Somebody please correct me if i'm wrong.

[hurlock1]

I'm wondering if anybody here has heard how abuse the to medicare system is leading to the collapse of the healthcare system. "Those poor pharmaceutical companies" They're charging that much because they can! "See a need, fill a need!" And charge people through their. . .

[paris]

It is kind of like the cost of chemo.  My bills for the chemo infusions were enormous, but these are specific drugs for a specific need.  My arenesp has always been paid for, thank goodness.   My hemoglobin was  7 or 8 until I got the wonder drug, epo.   

[RightSide]

I thought before the Epogen we all had to have more transfusions, wasn't that the only way to correct anemia previously?
Which increases antibodies and more problems with getting a transplant. Somebody please correct me if i'm wrong.

Yeah, at my dialysis center, one of the older nurses told me that when she started out in this job 20 years ago, dialysis patients got monthly transfusions. They would hang up the blood drip at the dialysis machine.

And that was risky:  Hepatitis, HIV, allergic reactions (making kidney transplants more problematic), the whole nine yards.

Actually, when I was first diagnosed with ESRD, my hemoglobin count was so low that my neph decided that even Epogen/Aronesp would take too long to work.  So I started off with two units of blood transfusion.

[gotalife]

So true! When I was diagnosed in 1974, started dialysis in 1978-1981, I had many blood transfusions, also plasma exchanges.  There were alot of risks involved..b4 1992(or was it 1994?), they hadn't tested for those as RightSide states. Many individuals who have had transfusions, tattoo's may not know if they may be carrying these virus's.

What is strange, it does normally raise antibodies..I even had a baby, which also increases anitbodies, a year ago I got evaluated for a 3rd transplant..I thought for sure my antibodies would be high. Turns out the antibodies were at 0!...I asked my transplant coordinator to make sure she had the right patient record in front of her..sure enough she did.  Am I one of those 'Puzzle People' ? 

[sico]

Actually, when I was first diagnosed with ESRD, my hemoglobin count was so low that my neph decided that even Epogen/Aronesp would take too long to work.  So I started off with two units of blood transfusion.

Same here, i had 2 or 3. All a bit of a blur now though.

I asked my transplant coordinator to make sure she had the right patient record in front of her..sure enough she did.  Am I one of those 'Puzzle People' ? 

It would have been hard to believe, but good news.

[calypso]

Thats nothin, 1 round of vancomycin (21 days) cost $5500.

[Zach]

Those with Mediacare as primary, EPO costs about $10.00 per 1,000 units.

Also, back in the old days before EPO my center gave the men intramuscular injections of Deca Durablin to help with our hemoglobin levels.  We all were given folic acid right after hemodialysis treatment.

As for cheating the American taxpayer, here's a recent article about EPO, etc,:

Amgen suit unveils industry 'overfilling' practices

" ... A lawsuit launched against Amgen Inc. on Oct. 30 raises important questions about what is accepted practice when it comes to manufacturing and administering certain drugs and whether the company encouraged the fraudulent sale of free drugs to increase their use.

The fifteen state attorneys general behind the suit allege that Amgen exceeded the amount of “overfill” necessary in its vials of anemia drug Aranesp and then its sales staff used that extra drug, placed in each vial so that a full dose can be extracted and administered with a needle, to encourage purchases and the false billing of Medicaid for the additional medicine...."

Read more about it:
http://www.vcstar.com/news/2009/nov/10/amgen-suit-unveils-industry-overfilling/?print=1

I posted about this issue here at IHD a few years back.

 

[hurlock1]

Thats nothin, 1 round of vancomycin (21 days) cost $5500.

A "round" of Epogen of 21 days is $14700.00

[Swee_tone]

What does the Aranesp cost in comparison to Epogen?

[calypso]

A "round" of Epogen of 21 days is $14700.00

Where did you get that figure from? That doesn't sound right. Unless you mean for an entire dialysis unit. My figure was per person.

[YLGuy]

The cost is going to vary based on the amount of epogen you get.  I get about 1/2 of what I used to get.

[billybags]

When my husband was on hemo he had 2 epo injections through his lines twice a week. He has just returned to CAPD and has gone back on to an injection call MERCEA apparently it is a different kind of epo that lasts, wait for it a month I dont know whether this is cost cutting or what.it is supposed to have the same effect as epo. Has any one on here heard of it or taken it? We  live in England.

[*kana*]

A "round" of Epogen of 21 days is $14700.00

Shoot, I'm glad I read this post again because I remembered I left 5 vials of Epo in my car!      Holy crap, I'm relieved that it has been cold out!

[Zach]

When my husband was on hemo he had 2 epo injections through his lines twice a week. He has just returned to CAPD and has gone back on to an injection call MERCEA apparently it is a different kind of epo that lasts, wait for it a month I dont know whether this is cost cutting or what.it is supposed to have the same effect as epo. Has any one on here heard of it or taken it? We  live in England.

MERCEA is the same as Aranesp in the States, and it is longer-acting, thus the need for fewer injections.
The real issue is his hemoglobin, which should be between 10.5 and 12.5 g/dl.

Here's the UK Kidney Foundation's "Know your Numbers."
http://www.kidney.org.uk/Medical-Info/other/know_nos.html